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Li LM, Liu XD, Liu Y, Liu TT, Zhang ZL. Efficacy of high-voltage, long-duration pulsed radiofrequency for the treatment of acute herpes zoster-related trigeminal neuralgia in a patient with permanent pacemaker. Korean J Pain 2024; 37:178-181. [PMID: 38439178 PMCID: PMC10985491 DOI: 10.3344/kjp.23324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 03/07/2024] Open
Affiliation(s)
- Li-Mei Li
- Department of Pain Management, The First Hospital of Qinhuangdao, Hebei, China
| | - Xiao-Dong Liu
- Department of Pain Management, The First Hospital of Qinhuangdao, Hebei, China
| | - Yue Liu
- Department of Pain Management, The First Hospital of Qinhuangdao, Hebei, China
| | - Ting-ting Liu
- Department of Pain Management, The First Hospital of Qinhuangdao, Hebei, China
| | - Zhi-Li Zhang
- Department of Pain Management, The First Hospital of Qinhuangdao, Hebei, China
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2
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Wang Y, Jia Y, Wang Z, Feng G, Ma Y, Fan Z, Liu M, Feng K, Wang T. Efficacy and Safety of High-Voltage Pulsed Radiofrequency versus Standard-Voltage Pulsed Radiofrequency for Patients with Neuropathic Pain: A Literature Review and Meta-Analysis. J Pain Res 2024; 17:851-863. [PMID: 38464903 PMCID: PMC10922952 DOI: 10.2147/jpr.s439909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/23/2024] [Indexed: 03/12/2024] Open
Abstract
Background Neuropathic pain (NP) is recognized as one of the most difficult pain syndromes which lacks a safe, well-tolerated and effective treatment. Pulsed radiofrequency (PRF), a novel and minimally invasive interventions, has been introduced to alleviate various types of NP. Previous studies reported PRF with higher voltage could further improve the treatment efficacy. Therefore, we conducted this systematic review and meta-analysis to determine whether high-voltage PRF is superior to standard-voltage PRF for the treatment of NP patients. Methods Databases published from the date of inception until 15 March 2022 on PubMed/MEDLINE, EMBASE, Web of Science and the Cochrane Library were searched for RCTs comparing high-voltage PRF and standard-voltage PRF in NP patients. The primary outcome measures were the efficiency rates of NP patients with high-voltage PRF or standard-voltage PRF treatment. Data analysis was conducted using the Review Manager software (RevMan V.5.3). Results Six RCTs involving 423 patients were included in our meta-analysis. Compared with standard-voltage PRF group, the high-voltage PRF group attained a higher efficiency rate at 1 month (P = 0.04; I2 = 0%), 3 months (P = 0.04; I2 = 0%), 6 months (P = 0.002; I2 = 0%) post-procedure respectively. There was no significant difference in the complications between the two groups. Conclusion Our study supported that high-voltage PRF attained more satisfactory efficacy than standard-voltage PRF without increased side effects. High-voltage PRF could be a promising, effective, minimally invasive technology for NP patients.
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Affiliation(s)
- Yu Wang
- Department of Neurosurgery, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, People’s Republic of China
- College of Rehabilitation, Capital Medical University, Beijing, People's Republic of China
| | - Yitong Jia
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zheng Wang
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Guang Feng
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yanhui Ma
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhen Fan
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Miao Liu
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Kunpeng Feng
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Tianlong Wang
- Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
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3
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Rui M, Ni H, Xie K, Xu L, Yao M. Progress in Radiofrequency Therapy for Zoster-Associated Pain About Parameters, Modes, Targets, and Combined Therapy: A Narrative Review. Pain Ther 2024; 13:23-32. [PMID: 37962817 PMCID: PMC10796860 DOI: 10.1007/s40122-023-00561-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Zoster-associated pain (ZAP) is a painful condition that significantly impacts a patient's quality of life, often leading to postherpetic neuralgia (PHN). Over 30% of patients with herpes probably experience PHN. However, the understanding and treatment of ZAP remain inadequate. Common interventional treatments include radiofrequency therapy, nerve blocks, epidural block, and spinal cord electrical stimulation. Among these, radiofrequency therapy is widely used for pain control in ZAP, but the standard pulsed radiofrequency technique can still be improved. Researchers have explored different radiofrequency parameters, modes, targets, and combined treatments to enhance the therapeutic effect. In this paper, we review the latest research findings and incorporate our own departmental investigations. We conclude that high-voltage, long-duration pulsed radiofrequency and radiofrequency thermocoagulation therapy have shown improved therapeutic outcomes, despite some remaining limitations. Emphasis is placed on safety in intercostal nerve and extracranial nerve radiofrequency treatments. Combination therapy is also safe and effective; however, many studies have a low grade of evidence. Further high-quality research and systematic reviews are needed.
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Affiliation(s)
- Min Rui
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Jiaxing, China
| | - Huadong Ni
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Jiaxing, China
- Institute of Neuroscience, Soochow University, No.199 Renai Road, Suzhou, China
| | - Keyue Xie
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Jiaxing, China
| | - Longsheng Xu
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Jiaxing, China
| | - Ming Yao
- Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Jiaxing, China.
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4
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Ma J, Wan Y, Yang L, Huang D, Zhou H. Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review. Ann Med 2023; 55:2288826. [PMID: 38048401 PMCID: PMC10836271 DOI: 10.1080/07853890.2023.2288826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 11/23/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Effective pain control of herpes zoster ophthalmicus (HZO) is not only essential to attenuate the clinical symptoms but to reduce the risk of postherpetic neuralgia development. Recently, neuromodulation therapy has been one promising option for neuropathic pain and increasingly applied in management of zoster-related pain. One key factor of neuromodulation treatment is the therapeutic site for the impaired nerves. In this study we aim to investigate one novel dual-neuromodulation strategy, targeting the level of the peripheral branch and trigeminal ganglion, in the pain management of HZO. METHODS Dual neuromodulation strategy combining short-term peripheral nerve stimulation (PNS) with pulsed radiofrequency (PRF) of trigeminal ganglion was compared with single PNS treatment for HZO-related pain. Clinical recordings of patients were retrospectively reviewed. The primary outcome was the pain severity, assessed by the visual analogue scale (VAS) before and after neuromodulation therapy. RESULTS PNS achieved significant relief of pain with or without PRF treatment before discharge, which provided enduring therapeutic effect up to 12-month follow-up. The mean reduction of VAS was 6.7 ± 1.4 in dual modulation therapy (n = 13) at last follow-up and 5.4 ± 1.5 in PNS subgroup (n = 20), respectively. Moreover, dual modulation strategy provided better control of pain compared with PNS therapy alone at each time point. CONCLUSION It is feasible and effective to combine the PNS and PRF in pain management of HZO. This novel dual modulation strategy of trigeminal pathway may provide additional therapeutic effects of pain symptoms in HZO population.
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Affiliation(s)
- Jiahui Ma
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Yaling Wan
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Liuqing Yang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Dong Huang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
- Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
| | - Haocheng Zhou
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
- Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
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5
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Tang J, Zhang Y, Liu C, Zeng A, Song L. Therapeutic Strategies for Postherpetic Neuralgia: Mechanisms, Treatments, and Perspectives. Curr Pain Headache Rep 2023; 27:307-319. [PMID: 37493871 DOI: 10.1007/s11916-023-01146-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE OF REVIEW Postherpetic neuralgia is an annoying pain that mainly affects older people. In order to give patients more options, this review summarizes the pharmacological and interventional treatments for postherpetic neuralgia and updates the research on the efficacy, thereby providing doctors with more treatment options. The adverse effects and effective doses of its various treatments are also presented so that the therapy can be prescribed according to their concrete physical conditions. In a word, this review is dedicated to providing a comprehensive overview of the treatment options for postherpetic neuralgia and offering patients more choices. RECENT FINDINGS Combinational therapy is more excellent than monotherapy. The local anesthesia and gabapentin comprised outstanding compatibility. In addition, two therapeutic tools for PHN patients, especially for the intractable ones, electroacupuncture (EA), and osteopathic manipulative treatment (OMT), show their efficacy and become potential options to alleviate pain. In terms of treatment, guidelines recommend patients use tricyclic antidepressants (TCAs), gabapentin, pregabalin, and 5% lidocaine patches as the first-line medications, and gabapentin is investigated most, especially the gabapentin enacarbil (GEn). And drug efficacy can be limited by adverse effects and tolerated doses. Interventional treatments, with their invasiveness and operational difficulty, are usually considered for intractable patients. Combinational therapies may be used when a single therapy cannot achieve the desired effect. Therapies such as OMT and EA have also been proposed to palliate pain in some cases, and future directions of treatment may be investigated in Chinese medicine and acupuncture.
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Affiliation(s)
- Jiayu Tang
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China
| | - Yunchao Zhang
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China
| | - Chenxin Liu
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China
| | - Anqi Zeng
- Institute of Translational Pharmacology and Clinical Application, Sichuan Academy of Chinese Medical Science, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Linjiang Song
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People's Republic of China.
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Wang C, Dou Z, Yan M, Wang B. Efficacy and Safety of Pulsed Radiofrequency in Herpes Zoster Related Trigeminal Neuralgia: A Systematic Review and Meta-Analysis. J Pain Res 2023; 16:341-355. [PMID: 36756203 PMCID: PMC9901482 DOI: 10.2147/jpr.s396209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose Pulsed radiofrequency (PRF) is a neuromodulation technique for neuropathic pain. However, the effects of PRF on zoster-related trigeminal neuralgia (TN) remain unclear. The purpose of this meta-analysis is to investigate the efficacy and safety of PRF in the management of zoster-related TN. Patients and Methods We searched PubMed, Embase, Cochrane Library, Chinese Biomedical Database (CBM), Chinese National Knowledge Infrastructure (CNKI), and Wanfang for randomized controlled trials from their inception to August 2022. The primary clinical outcomes included pain intensity and adverse events. Secondary clinical outcomes included pain remission rate, trigeminal postherpetic neuralgia (TPHN) incidence, rescue analgesic dose, sleep quality, and quality of life (QoL). Results Eight studies with 788 participants were included for final analysis. PRF group exhibited lower pain scores (week 1: MD -2.10, 95% CI -3.28 to -0.93, P=0.0005; week 4: MD -1.56, 95% CI -2.60 to -0.51, P=0.003; week 12: MD -1.52, 95% CI -2.68 to -0.35, P=0.01), lower risk of TPHN incidence (RR 0.22, 95% CI 0.06 to 0.81, P=0.02) and better sleep quality (week 4: MD -2.52, 95% CI -3.28 to -1.77, P<0.01; week 12: MD -2.25, 95% CI -2.90 to -1.60, P<0.01) than control group. Besides, pain remission rate (RR 1.08, 95% CI 0.93 to 1.26, P=0.31) and adverse events (RR 0.95, 95% CI 0.71 to 1.27, P=0.74) were comparable in both groups. Conclusion PRF is an effective and safe treatment and it yields better effects in pain relief, improvement of sleep quality, and prevention of developing TPHN. Although PRF provides a comparable pain remission rate with the control, it is still a preferred and alternative treatment for relieving zoster-related facial pain.
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Affiliation(s)
- Chenhui Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhi Dou
- Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Mengwei Yan
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Baoguo Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, People’s Republic of China,Correspondence: Baoguo Wang, Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, No. 50 Yikesong Street, Haidian District, Beijing, 100095, People’s Republic of China, Tel/Fax +86 10 6285 6766, Email
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7
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Wan CF, Song T. Comparison of Two Different Pulsed Radiofrequency Modes for Prevention of Postherpetic Neuralgia in Elderly Patients With Acute/Subacute Trigeminal Herpes Zoster. Neuromodulation 2022; 25:1364-1371. [PMID: 34008278 DOI: 10.1111/ner.13457] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Trigeminal postherpetic neuralgia (PHN) is often refractory to treatment. Pulsed radiofrequency (PRF) neuromodulation can help in preventing PHN after herpes zoster. This study aimed to compare the efficacy and safety of two different PRF modes on gasserian ganglion neuromodulation in elderly patients with acute/subacute trigeminal herpes zoster. MATERIALS AND METHODS A total of 120 elderly patients with acute or subacute (within past three months) trigeminal herpes zoster were randomized to receive either a single cycle of high-voltage, long-duration PRF (HL-PRF group; N = 60) or three cycles of standard PRF (S-PRF group; N = 60). Patients were followed up for six months after treatment. Visual analog scale (VAS) pain score, 36-Item Short Form Health Survey (SF-36) score, and pregabalin at baseline and at different time points during follow-up were recorded. RESULTS VAS and SF-36 scores declined significantly from baseline levels in both groups (p < 0.001). The scores were significantly lower in the HL-PRF group than in the S-PRF group at some time points (p < 0.05). The mean dose of pregabalin was significantly lower in the HL-PRF group than in the S-PRF group on days 3, 14, and 28 after treatment (p < 0.05). No serious adverse events occurred in either group. CONCLUSION HL-PRF neuromodulation of the gasserian ganglion appears to be more effective than S-PRF for preventing PHN in the elderly. CLINICAL TRIAL REGISTRATION ChiCTR2000038775.
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Affiliation(s)
- Cheng-Fu Wan
- Department of Pain Medicine, the First Affiliated Hospital to China Medical University, Shenyang, China
| | - Tao Song
- Department of Pain Medicine, the First Affiliated Hospital to China Medical University, Shenyang, China.
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Liu L, Zhang WJ, Xu SX, Guo WS, Yan RR, Jiang XH, Li SY, Sun T. Propensity score matching comparing short-term nerve electrical stimulation to pulsed radiofrequency for herpes zoster-associated pain: A retrospective study. Front Mol Neurosci 2022; 15:1069058. [PMID: 36518187 PMCID: PMC9742239 DOI: 10.3389/fnmol.2022.1069058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 12/14/2023] Open
Abstract
BACKGROUND Zoster-associated pain (ZAP) is notoriously difficult to treat. Pulsed radiofrequency (PRF) and short-term nerve electrical stimulation (st-NES) have been proven effective treatments for ZAP. However, it is still unclear which technique provides improved analgesia in ZAP. This study is based on a large-scale, long-term follow-up to evaluate the efficacy and safety between st-NES and PRF. MATERIALS AND METHODS All eligible ZAP patients treated with st-NES or PRF in our department were enrolled. Cohorts were divided into the st-NES group and the PRF group. A 1:1 ratio propensity score matching (PSM) was used to balance the baseline characteristics. The PS-matched cohort was adopted to investigate the efficacy and safety of the two treatments. The ordinal regression analysis was performed to determine the variables affecting the treatment effect of ZAP. RESULTS A total of 226 patients were included after PSM. The numerical rating scale (NRS) scores in st-NES and PRF groups considerably reduced compared to baseline levels after treatment. The NRS scores in the st-NES group were obviously lower than those in the PRF group at discharge, 1, 3, 6, 12, and 24 months. During the follow-up period, the NRS reduction rate remained higher in the st-NES group than in the PRF group (P < 0.01). The dosage of medication, Pittsburgh Sleep Quality Index (PSQI) score, and the number of patients with aggravated pain after discharge in the st-NES group were significantly less than in the PRF group after treatment. CONCLUSION Short-term nerve electrical stimulation has been shown to be more advantageous than PRF for pain relief and quality of life improvement for ZAP patients.
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Affiliation(s)
- Liu Liu
- Department of Pain Management, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Wen-jing Zhang
- Department of Pain Management, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Shu-xiang Xu
- Department of Pain Management, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Wen-shuai Guo
- Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ran-ran Yan
- Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiao-han Jiang
- Department of Pain Management, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Shi-yao Li
- Department of Pain Management, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Tao Sun
- Department of Pain Management, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Fan X, Ren H, Xu F, Lu Z, Ma L, Kong C, Wang T, Bu H, Huang W. Comparison of the Efficacy of Short-term Peripheral Nerve Stimulation and Pulsed Radiofrequency for Treating Herpes Zoster Ophthalmicus Neuralgia. Clin J Pain 2022; 38:686-692. [PMID: 36173138 PMCID: PMC9555752 DOI: 10.1097/ajp.0000000000001074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/03/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the effect of therapy with peripheral nerve stimulation (PNS) and pulsed radiofrequency (PRF) combined or PNS and PRF separately in patients with herpes zoster ophthalmicus (HZO). MATERIALS AND METHODS This cohort study included 106 cases of HZO. Three groups were identified according to the type of treatment received: combination therapy (PNS+PRF) (n=38), PRF (n=37), and PNS (n=31). The observations at 0, 1, 2, and 4 weeks; 3 and 6 months; and 1 and 2 years after the operation were analyzed. Observations at each follow-up included baseline characteristics, Numerical Rating Scale (NRS) and the Pittsburgh Sleep Quality Index (PSQI), concomitant pain medication usage, relapse rate, and adverse events. RESULTS The postoperative NRS of all 3 groups were significantly lower than preoperative scores. The PSQI of the 3 groups was significantly improved postoperatively, and the concomitant pain medication gradually decreased. Regarding long-term efficacy, the pain NRS and PSQI scores of the PNS+PRF and PNS groups were significantly lower than those of the PRF group ( P <0.05), and the relapse rate of the PRF group was higher than that of the PNS+PRF and PNS groups ( P <0.05). No significant difference was observed between the PNS+PRF and the PNS groups. CONCLUSION Both PNS and PRF treatment of HZO can decrease the pain score, yielding no serious complications. The combination of PNS and PRF or PNS alone resulted in more significant pain relief than treatment with PRF alone. Thus, PNS therapy may be a better treatment option for HZO.
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Affiliation(s)
- Xiaochong Fan
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Huan Ren
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Fuxing Xu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Zhongyuan Lu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Letian Ma
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Cunlong Kong
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Tao Wang
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Huilian Bu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province
| | - Wenqi Huang
- Department of Anesthesiology, the First Affiliated Hospital Sun Yat-sen University, Guangzhou, Guangdong Province, China
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10
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Javier J, Wilton J, Galluccio F, Allam AES. Pulsed Radiofrequency for Postherpetic Trigeminal Neuralgia: A Case Report. Cureus 2022; 14:e28913. [PMID: 36237778 PMCID: PMC9547084 DOI: 10.7759/cureus.28913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 12/04/2022] Open
Abstract
Trigeminal postherpetic neuralgia has been reported to cause chronic headaches and facial pain. There are various modalities of treatment ranging from pharmacological to surgical treatment. However, these are frequently accompanied by undesirable side effects and minimal efficacy. Pulsed radiofrequency has been used to treat chronic pain but it is often seen as an unconventional treatment for postherpetic neuralgia. Nonetheless, the literature supports its use for alleviating pain with minimal complications. This case demonstrates that pulsed radiofrequency can successfully treat intractable pain secondary to postherpetic neuralgia affecting all three trigeminal dermatomes.
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11
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Sun Z, Liu L, Liu H, Luo F. Effect of CT-Guided Gasserian Ganglion Block with Local Anesthetics and Steroids on Acute/Subacute Zoster-Related Trigeminal Neuralgia: A Multicenter Retrospective Study. J Pain Res 2022; 15:2303-2313. [PMID: 35974906 PMCID: PMC9375984 DOI: 10.2147/jpr.s375257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To further evaluate the effects of gasserian ganglion block treatment with local anesthetics and steroids on patients with acute/subacute zoster-related trigeminal neuralgia. Patients and Methods This is a multicenteric retrospective study which included patients between the ages of 26–92 years, who suffered from acute/subacute zoster-related trigeminal neuralgia and had undergone CT-guided gasserian ganglion block. The medical records of these patients between January 13, 2016 and August 25, 2021 were retrieved, and the patients were followed up for 6 months. Follow-up outcomes were Numerical Rating Scale (NRS) scores, medications and dosage. The effective rate was defined as the number of cases with NRS score reduction of >50%/total number of cases×100% at 12 weeks postoperatively. Results The postoperative NRS scores were significantly decreased in all patients (P < 0.05), and NRS scores in acute zoster group were lower than those in subacute zoster group at different time points (P < 0.05). The percentage of patients who had a reduction of medication use value of >50% was 56.4% and the effective rate was 66.7% in all patients, at 3 months after the block treatment. There was no significant difference in the reduction of medication use value of >50% and the effective rates between the two groups. There were no intracranial hemorrhage, infection or other serious adverse effects in either groups. Conclusion CT-guided gasserian ganglion block with local anesthetics and steroids can be an effective and safe technique to relieve the pain of acute/subacute zoster-related trigeminal neuralgia.
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Affiliation(s)
- Zhe Sun
- Department of Day Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China
| | - Lu Liu
- Department of Day Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China
| | - Hongbing Liu
- Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China
| | - Fang Luo
- Department of Day Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China.,Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China
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12
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Anosike UG, Ouko I, Mwaura AW, Ongidi I, Mbonu CC. Phenotypes and Genotypes in Postherpetic Neuralgia Drug Therapy: A Narrative Mini-review. Clin J Pain 2022; 38:536-540. [PMID: 35703453 DOI: 10.1097/ajp.0000000000001045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/03/2022] [Indexed: 11/25/2022]
Abstract
Neuropathic pain is a debilitating symptom reported by patients presenting with postherpetic neuralgia (PHN). Efforts to alleviate this pain have been projected to lie in individualization of pharmacological treatment through pain phenotyping and subsequent investigations into the genetic basis of PHN therapy. Understanding the various mechanisms related to these phenotypes can aid in improvement of available treatment options and discovery of new ones. Knowledge and application of genetic variations in PHN, structural proteins, and genes can aid in ascertaining risk, susceptibility to, severity of, and protection from PHN. This review summarizes the most recent information that has been published on phenotypes and genotypes with possible clinical applications and directions for future research.
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Affiliation(s)
- Udochukwu G Anosike
- Faculty of Medicine, Nnamdi Azikiwe University College of Health Sciences, Awka, Nigeria
| | - Innocent Ouko
- Department of Human Anatomy, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Anita W Mwaura
- Department of Human Anatomy, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Ibsen Ongidi
- Department of Human Anatomy, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Chijioke C Mbonu
- Faculty of Medicine, Nnamdi Azikiwe University College of Health Sciences, Awka, Nigeria
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Brinker ST, Balchandani P, Seifert AC, Kim HJ, Yoon K. Feasibility of Upper Cranial Nerve Sonication in Human Application via Neuronavigated Single-Element Pulsed Focused Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:1045-1057. [PMID: 35341621 DOI: 10.1016/j.ultrasmedbio.2022.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
Sonicating deep brain regions with pulsed focused ultrasound using magnetic resonance imaging-guided neuronavigation single-element piezoelectric transducers is a new area of exploration for neuromodulation. Upper cranial nerves such as the trigeminal nerve and other nerves responsible for sensory/motor functions in the head may be potential targets for ultrasound pain therapy. The location of upper cranial nerves close to the skull base poses additional challenges when compared with conventional cortical or middle brain targets. In the work described here, a series of computational and empirical testing methods using human skull specimens were conducted to assess the feasibility of sonicating the trigeminal pathway near the sphenoid bone region. The results indicate a transducer with a focal length of 120 mm and diameter of 85 mm (350 kHz) can deliver sonication to upper cranial nerve regions with spatial accuracy comparable to that of focused ultrasound brain targets used in previous human studies. Temperature measurements in cortical bone and in the skull base with embedded thermocouples yield evidence of minimal bone heating. Conventional pulse parameters were found to cause reverberation interference patterns near the cranial floor; therefore, changes in pulse cycles and pulse repetition frequency were examined for reducing standing waves. Limitations and considerations for conducting ultradeep focal targeting in human applications are discussed.
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Affiliation(s)
- Spencer T Brinker
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA.
| | - Priti Balchandani
- BioMedical Engineering and Imaging Institute, Departments of Diagnostic, Molecular and Interventional Radiology, Neuroscience and Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alan C Seifert
- Biomedical Engineering and Imaging Institute, Department of Diagnostic, Molecular and Interventional Radiology, and Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hyo-Jin Kim
- Center for Healthcare Robotics, Korea Institute of Science and Technology, Seoul, South Korea
| | - Kyungho Yoon
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, Seoul, South Korea
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Update on Interventional Management of Neuropathic Pain: A Delphi Consensus of the Spanish Pain Society Neuropathic Pain Task Force. Medicina (B Aires) 2022; 58:medicina58050627. [PMID: 35630044 PMCID: PMC9146461 DOI: 10.3390/medicina58050627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/07/2023] Open
Abstract
Background and Objectives: Interventional management of neuropathic pain (NP) is available to the patients who do not obtain satisfactory pain relief with pharmacotherapy. Evidence supporting this is sparse and fragmented. We attempted to summarize and critically appraise the existing data to identify strategies that yield the greatest benefit, guide clinicians, and identify areas that merit further investigation. Material and Methods: A two-round Delphi survey that involved pain clinic specialists with experience in the research and management of NP was done over an ad hoc 26-item questionnaire made by the authors. Consensus on each statement was defined as either at least 80% endorsement or rejection after the 2nd round. Results: Thirty-five and 29 panelists participated in the 1st and 2nd round, respectively. Consensus was reached in 20 out of 26 statements. There is sufficient basis to treat postherpetic neuralgias and complex regional pain syndromes with progressive levels of invasiveness and failed back surgery syndrome with neuromodulation. Radiculopathies and localized NP can be treated with peripheral blocks, neuromodulation, or pulsed radiofrequency. Non-ablative radiofrequency and non-paresthetic neuromodulation are efficacious and better tolerated than ablative and suprathreshold procedures. Conclusions: A graded approach, from least to most invasive interventions has the potential to improve outcomes in many patients with common refractory NP conditions. Preliminary promising data warrant further research on new indications, and technical advances might enhance the safety and efficacy of current and future therapies.
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Dey S, Das G, Surange P, Agarwal A, Kothari K, Natarajan K, Mehta P, Sharma G, Siddhaye U, Jain N, Mohan VK. Radiofrequency ablation in chronic pain syndromes: An evidence- and consensus-based indian society for the study of pain guidelines, 2022. INDIAN JOURNAL OF PAIN 2022. [DOI: 10.4103/ijpn.ijpn_123_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Murugesan A, Raghuraman MS. Pulsed Radiofrequency of Stellate Ganglion for Neuropathic Pain Associated with Recurrent Pleural Leiomyosarcoma - A Case Report. Indian J Palliat Care 2021; 27:574-576. [PMID: 34898954 PMCID: PMC8655670 DOI: 10.25259/ijpc_110_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/12/2021] [Indexed: 11/20/2022] Open
Abstract
Pleural leiomyosarcomas are rare soft-tissue sarcomas. Neuropathic pain associated with such tumours can be quite debilitating. We present the case of a 62-year-old woman with chronic neuropathic pain refractory to pharmacologic interventions in association with recurrent pleural leiomyosarcoma. Pulsed radio-frequency of the stellate ganglion was performed after due consideration and planning as a palliative measure to provide pain relief. The patient was discharged the same day with pain score 0/10 and followed up for 3 years. The unique features of this case report are: (1) Different approach of the treatment modality and (2) longer follow-up.
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Affiliation(s)
- Anand Murugesan
- Department of Anesthesiology and Pain Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - M S Raghuraman
- Department of Anesthesiology and Pain Medicine, Sree Balaji Medical College and Hospital, BIHER, Chennai, Tamil Nadu, India
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Zhao L, Song T. Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients. Front Neurol 2021; 12:713366. [PMID: 34413827 PMCID: PMC8368125 DOI: 10.3389/fneur.2021.713366] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/02/2021] [Indexed: 12/18/2022] Open
Abstract
Objective: We aimed to report on the use of short-term high cervical spinal cord stimulation (SCS) combined with peripheral nerve stimulation (PNS) to successfully treat trigeminal postherpetic neuralgia (TPHN) affecting the V2 and V3 divisions. We also sought to use a novel PNS approach to the maxillary nerve next to the external opening of the foramen rotundum (FR) to treat TPHN at the V2 division. Method: Two elderly patients successfully treated with different neuromodulation methods for TPHN are presented in this case series. Results: The first case referred to an 83-year-old Chinese female patient with V2 and V3 TPHN who experienced a significant pain relief using a combination of short-term high cervical SCS at the C1–C2 level and PNS on the infraorbital nerve (ION). Case 2 was a 68-year-old Chinese male patient with V1 and V2 TPHN that obtained an excellent pain relief after having received short-term PNS on the supraorbital nerve (SON), the supratrochlear nerve (STN), and the maxillary nerve. Both reported improvements in their quality of life and ability to perform daily tasks during a 3-month follow-up period. Conclusions: Short-term high cervical SCS at the C1–C2 spinal segments may be a feasible method to treat recent-onset V3 TPHN in elderly patients. Additionally, by placing the stimulation lead next to the external FR opening, we demonstrated a novel PNS approach to the maxillary nerve not previously reported for TPHN therapy.
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Affiliation(s)
- Lin Zhao
- Department of Pain, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Tao Song
- Department of Pain, The First Affiliated Hospital of China Medical University, Shenyang, China
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Wen B, Wang Y, Zhang C, Xu W, Fu Z. Efficacy of different interventions for the treatment of postherpetic neuralgia: a Bayesian network meta-analysis. J Int Med Res 2021; 48:300060520977416. [PMID: 33317382 PMCID: PMC7739127 DOI: 10.1177/0300060520977416] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective We aimed to perform a network meta-analysis that combined both direct and indirect evidence to compare the relative efficacy of interventional therapies to treat patients with postherpetic neuralgia (PHN) and to determine the treatments’ superiority and validity. Method A conventional paired meta-analysis was performed. This was followed by a network meta-analysis using the Bayesian framework. Results Botulinum toxin type A and pulsed radiofrequency (PRF) were the two most effective individual interventions. For combination therapy, PRF + nerve block (NB) was the best choice, followed by subcutaneous injection or local infiltration (SC) + NB + ozone (O3). However, the combination of PRF + NB + SC showed reduced the efficacy compared with each treatment and was highly invasive for patients. After a long-term follow-up, PRF was shown to be the most effective therapy for treating patients with PHN. Conclusions Regular anti-neuropathic drug administration that was accompanied by interventional therapies at an early stage is the best choice to treat patients with PHN. Appropriate combinations of different interventions show improved pain relief. Clinicians should manage therapeutic regimens on the basis of the patients specific condition and existing measures and strive to achieve personalized treatment.
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Affiliation(s)
- Bei Wen
- Department of Pain Management, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Yajie Wang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Cong Zhang
- Department of Orthopedics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Weicheng Xu
- Department of Orthopedics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Zhijian Fu
- Department of Pain Management, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
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Application of Nalbuphine in Trigeminal Ganglion Pulse Radiofrequency Surgery in Patients with Postherpetic Neuralgia. Pain Res Manag 2021; 2021:6623112. [PMID: 33747319 PMCID: PMC7943312 DOI: 10.1155/2021/6623112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/02/2021] [Accepted: 02/23/2021] [Indexed: 02/05/2023]
Abstract
This study aimed to explore the application value of nalbuphine in pulsed radiofrequency operation of trigeminal ganglion in patients with postherpetic neuralgia (PHN). Thirty patients with PHN were randomly divided into the nalbuphine (Nalbu) group and ketorolac tromethamine (KT) group and received CT-guided pulsed radiofrequency surgery on trigeminal ganglion. The numeric rating scale (NRS) scores of patients were recorded at preoperative, intraoperative, and postoperative time points, before going to bed, and the next morning after the operation. In addition, the number of breakthrough pain before operation and within 24 hours after operation, the incidence of nausea and vomiting within 24 hours after surgery, and the patient's sleep quality before and on the day after surgery were evaluated. The outcome data demonstrated that patients treated with nalbuphine had lower NRS scores after the pulse radiofrequency operation during and after the pulse radiofrequency operation compared to those with KT. In addition, nalbuphine effectively decreased the number of breakthrough pain, reduced the occurrence of nausea and vomiting after surgery, and improved the sleep quality. In conclusion, intramuscular injection of nalbuphine 30 min before trigeminal ganglion pulse radiofrequency surgery can be conducive to pain relief and improve the postoperative comfort of patients, providing an effective alternative for the alleviation of PHN in clinic.
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[Interdisciplinary position paper: the value of radiofrequency denervation in the treatment of chronic pain]. Schmerz 2021; 35:124-129. [PMID: 33447917 DOI: 10.1007/s00482-020-00526-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
Radiofrequency denervation has been established for many years as an important minimally invasive procedure for the treatment of chronic pain conditions. Positive experiences of many users for various indications are contrasted by a nonuniform evidence. With meticulous patient selection and correct assessment of the indications a longer term reduction of pain, a reduced need for analgesics and an improvement in the quality of life can be achieved. The aim of this interdisciplinary position paper is to present the value of radiofrequency denervation in the treatment of chronic pain. The summarized recommendations of the expert group are based on the available evidence and on the clinical experiences of Austrian centers that frequently implement the procedure. The position paper contains recommendations on patient selection and proven indications. We discribe safety aspects, complications, side effects and contraindications.
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Supraorbital Nerve Radiofrequency for Severe Neuralgia Caused by Herpes Zoster Ophthalmicus. Pain Res Manag 2020; 2020:3191782. [PMID: 33062083 PMCID: PMC7533012 DOI: 10.1155/2020/3191782] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/11/2020] [Accepted: 07/06/2020] [Indexed: 12/17/2022]
Abstract
Background Radiofrequency of the Gasserian ganglion can be used for ophthalmic herpetic neuralgia (OHN), but it is associated with complications. This study aimed to use the supraorbital nerve for computed tomography- (CT-) guided radiofrequency thermocoagulation to treat refractory OHN. Methods This was a retrospective case series study of patients with simple or combined OHN treated at our hospital between 06/2012 and 06/2018. The numerical rating score (NRS), spontaneous pain, allodynia, gabapentin dosage, paracetamol/oxycodone dosage, patient global impression of change (PGIC) score, Barrow numbness score, postoperative 360-day recurrence rate, and complications were recorded before the operation and at 1, 30, 90, 180, and 360 days after the operation. Results Compared with baseline, the NRS was decreased, and PGIC was increased at postoperative 1, 30, 90, 180, and 360 days, and the gabapentin and paracetamol oxycodone doses at postoperative 30, 90, 180, and 360 days were decreased (all P < 0.001). Compared with 1 day after the operation, numbness was decreased at 30, 90, 180, and 360 days after the operation (P < 0.001). Compared with baseline, the number of patients with allodynia at each time point after the operation was decreased (P < 0.001), but without a difference for spontaneous pain (P=0.407). No subjects showed drooping eyelid, corneal ulcers, eyeball damage, decreased vision, and other severe complications. Conclusion CT-guided supraorbital nerve radiofrequency thermocoagulation for the treatment of OHN can effectively relieve pain and reduce the dose of analgesics, without any serious complication. This study suggests that this technique is feasible and applicable to clinical practice.
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Bioinformatics Analysis of Genes and Mechanisms in Postherpetic Neuralgia. Pain Res Manag 2020; 2020:1380504. [PMID: 33029266 PMCID: PMC7532419 DOI: 10.1155/2020/1380504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/29/2020] [Indexed: 01/03/2023]
Abstract
Objective Elderly patients are prone to postherpetic neuralgia (PHN), which may cause anxiety, depression, and sleep disorders and reduce quality of life. As a result, the life quality of patients was seriously reduced. However, the pathogenesis of PHN has not been fully elucidated, and current treatments remain inadequate. Therefore, it is important to explore the molecular mechanism of PHN. Methods We analyzed the GSE64345 dataset, which includes gene expression from the ipsilateral dorsal root ganglia (DRG) of PHN model rats. Differentially expressed genes (DEGs) were identified and analyzed by Gene Ontology. Protein-protein interaction (PPI) network was constructed. The miRNA associated with neuropathic pain and inflammation was found in miRNet. Hub genes were identified and analyzed in Comparative Toxicogenomics Database (CTD). miRNA-mRNA networks associated with PHN were constructed. Results A total of 116 genes were up-regulated in the DRG of PHN rats, and 135 genes were down-regulated. Functional analysis revealed that variations were predominantly enriched for genes involved in neuroactive ligand-receptor interactions, the Jak-STAT signaling pathway, and calcium channel activity. Eleven and thirty-one miRNAs associated with neuropathic pain and inflammation, respectively, were found. Eight hub genes (S1PR1, OPRM1, PDYN, CXCL3, S1PR5, TBX5, TNNI3, MYL7, PTGDR2, and FBXW2) associated with PHN were identified. Conclusions Bioinformatics analysis is a useful tool to explore the mechanism and pathogenesis of PHN. The identified hub genes may participate in the onset and development of PHN and serve as therapeutic targets.
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Han R, Guo G, Ni Y, Wang Z, Yang L, Zhang J, Li X, Hu R, Huang D, Zhou H. Clinical Efficacy of Short-Term Peripheral Nerve Stimulation in Management of Facial Pain Associated With Herpes Zoster Ophthalmicus. Front Neurosci 2020; 14:574713. [PMID: 33100962 PMCID: PMC7546869 DOI: 10.3389/fnins.2020.574713] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/19/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Peripheral nerve stimulation may be an alternative option to treat severe facial pain. We assessed the application of peripheral nerve stimulation for pain management in patients with herpes zoster ophthalmicus. Method A retrospective analysis was conducted in patients suffering severe facial pain caused by ophthalmic herpetic lesions. We identified the change in pain severity before and after peripheral nerve stimulation for up to 12 months. Results Eighteen patients were enrolled. Their mean age was 70.8 ± 9.5 years. Fifteen patients presented with subacute pain for 1–3 months, and three patients suffered postherpetic neuralgia. Dramatic relief from pain was achieved in 83% of patients (15 out of 18) upon initial removal of the stimulator, with pain reduction of > 50%. The long-term analgesic effect was reported at the 6- and 12-month follow-ups, with reductions in the visual analog scale of 4.8 ± 1.2 (n = 18) and 5.4 ± 1.4 (n = 11), respectively. The prevalence of postherpetic neuralgia was 7% (1 out of 15) in the subacute pain group. No obvious adverse effect was observed. Conclusion Peripheral nerve stimulation may be an efficacious and safe approach for pain control in patients with herpes zoster ophthalmicus.
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Affiliation(s)
- Rui Han
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Gangwen Guo
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Yuncheng Ni
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Ziyang Wang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Liuqing Yang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Jianping Zhang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Xuelian Li
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Rong Hu
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China
| | - Dong Huang
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China.,Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
| | - Haocheng Zhou
- Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China.,Hunan Key Laboratory of Brain Homeostasis, Central South University, Changsha, China
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Ding Y, Li H, Hong T, Yao P. Efficacy of Pulsed Radiofrequency to Cervical Nerve Root for Postherpetic Neuralgia in Upper Extremity. Front Neurosci 2020; 14:377. [PMID: 32372914 PMCID: PMC7186594 DOI: 10.3389/fnins.2020.00377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background Postherpetic neuralgia (PHN) seriously affects a patient’s quality of life, and it is urgent to find a method that can effectively alleviate the PHN of the upper extremity. Objective To observe the Efficacy of pulsed radiofrequency (PRF) to cervical nerve root for PHN in upper extremity under CT guidance. Study Design Retrospective comparative study. Setting Shengjing Hospital of China Medical University. Methods Fifty patients with PHN in upper extremity were enrolled in Pain Management. Patients were randomized into two groups: cervical nerve root block (A group, n = 25) and cervical nerve root PRF (B group, n = 25). At each observation time, the general characteristics, visual analog scale (VAS), quality of life scores assessment (SF-36), the total efficacy rate, dosage of antiepileptic and narcotic analgesics, and the incidence of complications were followed up. Results Compared with the preoperative, the postoperative VAS decreased, the physical component summary (PCS) and the mental component summary (MCS) increased in both groups (P < 0.05). The differences between group B and group A were statistically significant after 1 month, which could be maintained for 1 year (P < 0.05). The total efficacy rate of group A and group B was 52.0% and 80.0% at 1 Year, respectively. The total efficacy rate of group B was higher than that of group A (P < 0.05). The dosage of antiepileptic and narcotic analgesics in group B decreased significantly, and the decline was significant compared with group A (P < 0.05). The incidence of complications between the two groups were similar (P > 0.05). Conclusion CT-guided PRF to cervical nerve root for the treatment of PHN in the upper extremity is safe and effective. PRF can replicate the location of pain, precise positioning, reduce trauma, and increased pain relief rate.
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Affiliation(s)
- Yuanyuan Ding
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hongxi Li
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tao Hong
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Peng Yao
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
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Post Herpetic Neuralgia: Recent Advancements. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2020. [DOI: 10.1007/s40138-020-00212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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